Aged care for couples

IntroductionOn April 25, 2016, the Centers for Medicare & Medicaid Services (CMS), released the Medicaid managed care final rule entitled, “Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, and Revisions Related to Third Party Liability.” The final rule revamps the 14-year-old managed care delivery system regulations by increasing state accountability and incentives to promote improved quality of care and access, strengthening program integrity, increasing consumer protection and reducing services churn. The final rule was published in the Federal Register on May 6, 2016.Though largely unchanged from the proposed rule, the final rule includes several notable revisions and clarifications. In addition to changes to the medical loss ratio (MLR) provisions, as addressed in the first article of this series, the final rule increases CHIP’s marketing flexibility, clarifies … [Read more...] about CMS’s Final Medicaid Rule Tweaks Proposed Rules Related to Marketing, Physician Incentive Arrangements and Long-term Care

The election of Donald J. Trump as the 45th President of the United States, along with the Republican control of the majority of both the House of Representatives and the Senate, will likely set in motion a major overhaul of the nation’s health care system. As a candidate, President-elect Trump strongly echoed calls to “repeal and replace” the Affordable Care Act (“ACA”) and also called for other reforms that would potentially affect Medicaid funding, pharmaceutical regulation, and the health insurance industry. Given the relative lack of detail in his policy proposals, it remains to be seen what specific health care policy changes the Trump Administration will present when President-elect Trump takes office in January 2017. However, a number of sources provide guidance as to potential policy proposals, including: (i) the Health Care page on the GreatAgain.gov website, (ii) the Health Care page on the Donald J. Trump campaign … [Read more...] about Trump Administration: Future of Health Care

Updated: Disgraced former U.S. Rep. Jesse Jackson Jr. and his wife, who until recently was a member of Chicago’s governing body, tearfully apologized on Wednesday for misusing $750,000 in campaign funds to pay for luxury items and cover other personal expenses.The 48-year-old ex-Congressman from Illinois asked a federal judge in Washington, D.C., to give his wife probation, so that she could continue to care for the couple’s two children, ages 9 and 13. He got a two-and-a-half-year prison term and three years of probation from U.S. District Court Judge Amy Berman Jackson (no relation to the defendants), according to the Associated Press and WLS.Meanwhile, Sandra Jackson, 49, asked for mercy for herself, another Associated Press article recounts.She got a 12-month term, a CBS Chicago report says.Her lawyer, chairman Dan Webb of Winston & Strawn, had sought probation, but a columnist for the Chicago Tribune said in an opinion video that the two Jacksons nonetheless had … [Read more...] about Jesse Jackson and his wife tearfully apologize for misusing $750K in campaign funds, both get time

A judge in a controversial child custody case in Texas has angrily stepped down after apparently being persuaded that a related judicial conduct investigation required him to do so.After Juvenile Court Judge John Phillips decided last year that Yolanda and Arnold Del Bosque were too old to raise the young grandchildren they had been caring for since infancy and had the two boys removed to a foster home, the couple—who were 59 and 52, respectively, at the time of the ruling—made an age bias complaint against him. Armed with a letter from the State Commission on Judicial Conduct stating that it is investigating the Del Bosques’ complaint, their lawyer, law professor Barbara Stalder of the University of Houston, asked Phillips to recuse himself from the custody case, according to an opinion piece in the Houston Chronicle.Although Phillips, according to Stalder, had no choice but to do so while awaiting an administrative judge’s ruling on her recusal motion, … [Read more...] about ‘Too Old’ Grandparents (59 and 52) Hope for Custody Under New Judge

As if the other drawbacks of aging weren’t al­ready bad enough, doing income taxes gets hard­er, too.The intuitive conclusion would seem to go in the other direction–that computing taxes should be less complicated for an individual or a couple easing into retirement. But it doesn’t always work that way, at least in the context of federal income taxes.Instead, older taxpayers must grapple with unfamiliar rules and formulas that kick in as they begin collecting Social Security benefits, sell houses, withdraw money from savings vehicles and fine-tune es­tate plans.Further complicating things is the fact that many of the long-standing rules in those areas have been replaced under tax laws passed in recent years–but because of sunset provisions, some of those new rules may be in effect for only a few more years, unless Congress acts to extend them.Meanwhile, the portion of the U.S. population that faces these tax issues is growing steadily. The 2000 … [Read more...] about The Rules Change with Age

Implementation of the Affordable Care ActOn March 4th Iowa Governor Terry Branstad (R) proposed his “Health Iowa Plan” as an alternative to Medicaid expansion in his state. Under his plan, Medicaid coverage will be provided to residents at or below 100% of the federal poverty level (FPL). Everyone else above would be placed into the federal-state partnership exchange being developed in Iowa with tax subsidies. Democrats in the state say Gov. Branstad’s plan would cost millions of dollars more and cover half as many people as the standard Medicaid expansion. An article with comments from the governor is available here. On March 7th U.S. Senator Tom Harkin (D-IA), Chairman of the Senate Health, Education, Labor & Pensions (HELP) Committee, said he expects that Department of Health and Human Services (HHS) Secretary Sebelius will reject Iowa’s plan. The latest details on Iowa’s proposed plan can be found here.On March 4th Florida … [Read more...] about Health Care Law Reform Update – March 11, 2013

The Supreme Court today largely upheld the challenged provisions of the Affordable Care Act (ACA). However, its legal rationale, particularly in relation to the individual mandate, diverged from the main focus of the briefs and oral arguments which had focused on questions related to the scope of Congressional authority under the Commerce Clause.The mandate requiring that most Americans maintain “minimum essential” health insurance coverage was upheld. Although it can be pointed out that a majority of the Court found that the provision was not a valid exercise of Congress’s Commerce Clause power (with potential implications for future cases), it determined that, constitutionally, the mandate can be treated as imposing a tax on those who do not have health insurance coverage and is within Congress’s taxing power.In the end, the law’s Medicaid expansion was upheld, with some important modifications the implications of which deserve careful consideration. … [Read more...] about Supreme Court Health Care Ruling: Preliminary Analysis & Implications Going Forward

Families negotiating difficult issues such as how to get Dad to give up his car keys or Mom to give up her house are using mediators to help with the conversation.Good mediators will help elderly parents be heard, National Public Radio reports. Baltimore lawyer and mediator Bob Rhudy told the network that even an elderly person with Alzheimer’s or dementia can express things such as “what family member that they are comfortable with, who they care for, respect, trust, where they like to live.”“They may not have the capability to make substantial legal or financial decisions, but they certainly have the ability to express opinions and wishes and desires,” he said.In one case, mediator Rikk Larsen came up with a solution to help an elderly man having trouble paying bills. The man’s accountant sent an assistant every couple of weeks to help with the task. “It became this kind of business meeting that the father had, and he got to maintain his … [Read more...] about Elder Mediators Help Families Negotiate Tough Issues of Aging

CA Minimum Wage Increase & Resulting 12.9% Salary Increase for Many Exempt Employees—AB 10Effective July 1, 2014, the California minimum wage will increase from $8 to $9 per hour, pursuant to AB 10. It will increase again to $10 per hour, effective January 1, 2016. We also expect that, not to be outdone, those municipalities with “Living Wage” Ordinances will likewise be boosting their rates and may not wait for July 1, 2014, to do so. All of that is something to monitor.The thing to be a little careful about now is budgeting for the salary level of your lower level exempt employees in 2014. It is well known that the Federal FLSA salary minimum is inadequate to preserve exempt status in the Golden State. Although it has been a while, you may recall there was a reason why your California supervisors are paid a little more than $33,280 per year, i.e., to preserve the exempt status, the monthly salary must be greater than two times the wages paid to … [Read more...] about 2013 California Employment Law Legislative Update: Things You Need to Know for 2014

The Patient Protection and Affordable Care Act (“PPACA”), as amended, contains significant new requirements for employers and their health plans. This summary describes the main provisions of PPACA, but not every provision of PPACA.This summary is divided into five sections:Plan Changes – Describes what health benefits a plan must cover (e.g., preventive care without cost-sharing) and restrictions a plan must eliminate (e.g., lifetime limits). Also includes new enrollment rules (e.g., covering older children).Employer and Insurer Administrative Requirements – Describes the administrative actions employers and insurers must take (e.g., reporting the value of health plan coverage on Form W-2).Tax Incentives / Penalties for Employers, TPAs and Insurers – An overview of tax benefits provided under PPACA (such as the early retiree reinsurance program), tax increases (e.g., additional FICA tax of 0.9%) and tax penalties that can apply (e.g., the $2,000 and … [Read more...] about The Patient Protection and Affordable Care Act Summary